Fraternal
Access the instructions and checklist.
State Required Forms
- Basket Clause Form (Paragraphs 19 & 20) (Domestic Only)
- Certificate of Advertising Compliance
- [IC 27-1-12-2(b)(17A), (17B) & (30A)]
- Indiana Fee and Retaliatory Fee Statement
- Insurer Profile Questionnaire
- Supplement to the State of Indiana Health Exhibit (ICHIA)
- Year-End Deposit Requirements
Online Services
Top FAQs I Want To...
- File a complaint
- Become an insurance producer
- Check out a health care provider
- Find a company's registered agent
- See a list of licensed insurance companies
- File a medical malpractice complaint
- Learn about Medicare
- Compare Medicare Supplement plans
- See what enforcement actions IDOI has taken
- Learn about COBRA coverage
- Know my HIPAA rights
- Form an insurance company
- File financial information for my insurance company
- Qualify under Indiana's Medical Malpractice Act
- Find a Bail Bond Agent
- Contact SHIP for information
